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Making sense of death is the life of this 'Working Stiff'

It can be tough trying to explain why you've made a career out of death. But it can be engaging if you bring to it the sensibilities of a medical examiner who's pored over the remains of hundreds of people who

Making sense of death is the life of this 'Working Stiff'

It can be tough trying to explain why you've made a career out of death.

But it can be engaging if you bring to it the sensibilities of a medical examiner who literally has had a hand in examining hundreds of people who died in sometimes gruesome, often sad circumstances. For Judy Melinek, author of the new book Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, that included being a rookie examiner doing autopsies of some of the 9/11 victims in New York.

Most of the book is devoted to her two years in the New York City Office of the Chief Medical Examiner. She started in July 2001, two months before the Sept. 11 attacks. She tries not to focus too much on the headline grabbers like that or the crash of American Airlines Flight 587 in New York. The book looks at routine and oddball cases alike, as well as the big ones. Consider:

• The cable guy: A young man fond of crystal meth locks himself out of his nine-story apartment building, goes to the roof and unspools a coaxial cable to rappel to his open eighth-floor window to get in. Cable snaps. "When the body reached me the next morning, it was a mess," she writes.

• KIlled by egg roll machine: This was no joke, she writes. An egg roll factory had its combination shredder/mixer blow apart, sending its huge central drum and blade flying. The blade injured several workers. The drum pinned another worker to the floor, crushing his upper chest. He died of suffocation.

• A firefighter: With all the bodies coming in from the 9/11 attack, her office decided on a naming convention: Disaster Manhattan (DM) followed by the number of the body or body part being examined. DM-01-00123 was a firefighter, "head bashed in, badly burned but easy to identify because his name was embroidered on his shirt. ... I made a mental note to give the next living firefighter I encountered a big hug, whether he wanted it or not."

The book is equal parts sober, clinical science (not for the squeamish, by the way) and heartfelt stories of victims and their families.

She has a quick answer for friends who keep telling her, "I don't understand how you can do it."

All training in medicine to some extent involves "a slow desensitization process," she says.

"In some ways, it's easier for me, because a dead body really is an object, no longer a person at all. More important, that dead body is not my only patient. The survivors are the ones who really matter. I work for them, too."

She's also particularly empathetic to those losing loved ones to suicide. Her own father took his life when she was just 13. "My dad's suicide led me to embrace life — to celebrate it and cling to it."

Mostly, she wrote the book with her husband, T.J. Mitchell, a stay-at-home dad for their three kids, to focus on the training that pathologists undergo and to inject reality into the public notions of a pathologist's life based on all those TV cop shows, though even her book has been optioned for possible TV development. (Mitchell and Melinek are also working on a forensic detective novel together.)

"The assumption is that pathology is perfect, and pathologists spring from the womb all-knowing and solve cases in 45 minutes. The reality is much different," Melinek says from California, where she now works for the Alameda County Coroner office and as an associate clinical professor at the University of California-San Francisco.

Melinek also points out that the nation's pathologists are a relatively small family — about 500 for the whole country. Indeed, there's a shortage that needs to be addressed, says Gregory Davis, chief coroner/medical examiner for Jefferson County, Ala., and president of the National Association of Medical Examiners.

Not everyone has the personality for this kind of work, Davis acknowledges, but another issue is pay: Pathologists who work in all those hospital labs going over blood, urine and tissue samples from patients make better money — perhaps twice the pay of the forensic pathologists who work for government agencies, he says. His organization is trying to work with federal agencies to seek loan forgiveness for all that medical school debt weighing on those who enter forensic pathology.

"Working Stiff" by Judy Melinek and T.J. Mitchell.(Photo: Scribner)

Melinek and her husband worried that the ghoulish things she saw in her work would change them, make them paranoid about the ways she or her family might die.

But her experience had the opposite effect, making her realize that nearly every fatality she examined was the result of something "dangerously mundane or something predictably hazardous."

So, she says, avoid jaywalking, wear your seatbelt, get exercise, watch your weight, stop smoking. "You know that yellow line on the subway platform? It's there for a reason," she writes. "Staying alive, as it turns out, is mostly common sense."

Her most "heartbreaking" autopsy came in her first week on the job in New York, a woman killed by a white minivan while she was jaywalking. Turns out the woman was pregnant.

"When I saw that perfect fetus, when I took it in my hands, my vision clouded over with tears and my professional reserve fell away. It was a boy, with 10 fingers and 10 toes ... I returned him to his mother's body, to be buried with her."

That message of compassion carries through the book.

"Every doctor has to cultivate compassion, to learn it, and then practice it," she writes. "To confront death every day, to see it for yourself, you have to love the living."